Y. EL Achhab

Le diabète de type 2 (DT2) représente un problème majeur de santé publique tant dans les pays développés que dans les pays en voie de développement. La gravité de cette maladie provient essentiellement des complications à long terme qui sont sources de handicaps, d' ...

Diabetes and erectile dysfunction in Morocco: epidemiological study among outpatients ABSTRACT We studied the relationship between erectile dysfunction (ED) and diabetes among 189 men (> 40 years) attending primary health care centres in Morocco. Of the 89 diabetic men, 82% had ED while only 17% of the 100 non-diabetic men had ED. The frequency of ED among diabetic men increased

A thesis in medicine is a scientific work which allows a medical student to acquire a Doctor of Medicine degree. It is therefore recommended that theses presented by students fulfill essential methodological criteria in order to obtain scientifically credible results and recommendations. The aim of this study was to assess the methodology of thesis presented to the Faculty of Medicine in Fez in 2008. We developed an evaluation table containing questions on the different sections of the IMRAD structure on which these theses were based and we estimated the proportion of theses that conformed to each criterion. There were 160 theses on various specialties presented in 2008. The majority of the theses (79.3%) were case series. Research questions were clearly expressed in 62.0% but the primary objectives were pertinent in only 52.0%. Our study shows that there were important deficiencies in the methodological rigor of the theses and very little representation of the theses in publications.

ABSTRACT Objective The aim of this study was the measurement of cancer patient’s satisfaction regarding health care services received during their hospitalizations. Methods A cross-sectional study of cancer patients treated at two oncology hospitals (Ibn Rochd in Casablanca and the National Institution of Oncology in Rabat) was assessed. A patient satisfaction questionnaire (EORTC IN-Patsat32) was used. The clinical, demographic and EORTC In-Patsat32 factors were evaluated for predictive significance. Results The mean age of the sample was 46.6 years (SD = 14.08, range 16 to 89), with a preponderance of females (66.5%). The majority of patients received chemotherapy (60.1%). The patients’ satisfaction had generally average scores below 52. Patients living in rural areas reported satisfaction more than residents in urban areas towards the comfort of the institution (p < 10−3). The patients’ satisfaction towards the nurses’ information provision, the waiting time and the comfort of the institution differed significantly by cancer localization. Satisfaction scores differed significantly by status of treatment towards services accessibility and comfort of cancer institutions. The multivariate modeling of different scales in the instrument showed that satisfaction towards the hospital access seem significantly lower in patients’ resident in rural areas, female and not yet received any treatment compared to those of urban, male and already under treatment. Conclusion This finding highlight the importance of undertaking further research on developing and measuring satisfaction markers, where such indicators could act as domains, alerting care providers and educators to areas and programmers’ requiring attention.

To investigate the relationship between mortality and BMI in older people, taking into account other established mortality risk factors. A total of 3,646 French community dwellers aged 65 years and older from PAQUID cohort study were included. Cox proportional-hazards analysis was used to assess association between BMI and mortality. Death occurred in 54.1% of the cohort more than 13 years: 68.99% of the underweight (BMI <19), 52.13% of the obese (BMI >30), 51.66% of the overweight (BMI 25-30), and 51.79% of the reference participants (BMI 22-25) died.The relative risk of death as a function of BMI, adjusted for gender and age, formed a U-shaped pattern, with larger risks associated with lower BMI (<22.0) and for BMI of 25.0 to 30.0 and BMI >/=30. (BMI 22.0-24.9 was the reference.) After adjustment for demographic factors, smoking history, and comorbidity, increased mortality risk persisted in underweight older people, BMI <18.5 and BMI 18.5-22 (respectively, HR = 1.45, 95% CI 1.17-1.78; HR = 1.27, 95% CI 1.12-1.43) compared with reference. Overweight (BMI 25-29.9) and obesity (>/=30) were not associated with increased mortality compared with the reference category (respectively, HR = 0.98, 95% IC 0.88-1.10; HR = 1.06, 95% IC 0.89-1.27). Similar relationships persisted for disabled participant. For nondisabled participant disability did not alter the associations for BMI of 25.0 and higher but for BMI less than 22.0, the risks become insignificantly different from those for the reference group. BMI below 22 kg/ m(2) is a risk factor for 13-year mortality in older people, but our findings suggest that overweight and obesity may not be associated to mortality after adjustment for established mortality risk factors.

Recent genome-wide association studies (GWAS) and previous approaches have identified many genetic variants associated with type 2 diabetes (T2D) in populations of European descent, but their contribution in Arab populations from North Africa is unknown. Our study aimed to validate these markers and to assess their combined effects, using large case-control studies of Moroccan and Tunisian individuals. Overall, 44 polymorphisms, located at 37 validated European loci, were first analyzed in 1055 normoglycaemic controls and 1193 T2D cases from Morocco. Associations and trends were then assessed in 942 normoglycaemic controls and 1446 T2D cases from Tunisia. Finally, their ability to discriminate cases from controls was evaluated. Carrying a genetic variant in BCL11A, ADAMTS9, IGF2BP2, WFS1, CDKAL1, TP53INP1, CDKN2A/B, TCF7L2, KCNQ1, HNF1A, FTO, MC4R and GCK increased the risk of T2D when assessing the Moroccan and Tunisian samples together. Each additional risk allele increased the susceptibility for developing the disease by 12% (P = 9.0 × 10(-9)). Genotype information for 13 polymorphisms slightly improved the classification of North Africans with and without T2D, as assessed by clinical parameters, with an increase in the area under the receiver operating characteristic curve from 0.64 to 0.67 (P = 0.004). In addition to TCF7L2, 12 additional loci were found to be shared between Europeans and North African Arabs. As for Europeans, the reliability of genetic testing based on these markers to determine the risk for T2D is low. More genome-wide studies, including next-generation sequencing, in North African populations are needed to identify the genetic variants responsible for ethnic disparities in T2D susceptibility.